Provider Demographics
NPI:1285739920
Name:WOLFF, MARK M (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:M
Last Name:WOLFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:215 S WADSWORTH BLVD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-1565
Mailing Address - Country:US
Mailing Address - Phone:303-986-5122
Mailing Address - Fax:303-986-9839
Practice Address - Street 1:215 S WADSWORTH BLVD
Practice Address - Street 2:SUITE 420
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-1565
Practice Address - Country:US
Practice Address - Phone:303-986-5122
Practice Address - Fax:303-986-9839
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1607111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC14503Medicare PIN
COT60507Medicare UPIN